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Bacteriological findings in children with haematological disorders

Abstract number: 902_p1432

Kowalska-Krochmal B.

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Objectives:

Infections in neutropenic children in the haematology ward is a significant therapeutical problem. The aim of this study was the analysis of frequency of isolation and antibiotic susceptibility of bacterial strains from children hospitalised in the Haematology Clinic in Wroclaw in the period 1999–2000 vs. 2001–2002.

Methods:

Various clinical samples (blood, urine, faeces, material from respiratory tract and other materials) were examined. Isolated bacterial strains were identified by bioMerieux tests. Antibiotic susceptibility was examined by ATB tests (bioMerieux) and the disc diffusion method (NCCLS).

Results:

During the periods compared the total number of isolated strains was 785 and 1923 (blood 194 and 283). Significant changes in percentage of Gram-negative and Gram-positive isolates from blood (from 30.4% to 55.8% and from 69.6% to 44.0%, respectively) were noticed. Among the 1923 bacterial strains isolated from all the materials in 2001–2002, 53% were Gram-positive and 47% Gram-negative. In the group of Gram-positive strains (n = 1017), coagulase-negative staphylococci (CNS), streptococci orale and enterococci were dominant (32%, 31% and 23% respectively); in the group of Gram-negative strains (n = 906) it was mainly Escherichia coli, nonfermentative rods (P. aeruginosa excluded), Klebsiella and Enterobacter (31%, 12%, 11% and 10%). The results of antibiotic susceptibility were as follows:

–in the group of Gram-positive bacteria glycopeptide-resistant strains were not found,

–there were 75% MRS (methicillin resistant Staphylococcus) strains among CNS and 24% among S. aureus,

–Increase in antibiotic resistance of Gram-negative rods especially among E. coli (to amoxicillin/clavulanic acid), P. aeruginosa (to netilmicin, ceftazidime) and other nonfermentative rods (to ceftazidime, piperacillin) was observed,

–Gram-negative rods were highly susceptible to imipenem (96%), meropenem (94%), piperacillin/tazobactam (84%), ciprofloxacin (80%) and ceftazidime (79%); among carbapenem-resistant strains there were mainly nonfermentative rods (P. aeruginosa inclusive).

Conclusions:

1. Rising trends were observed in the number of Gram-negative isolates from blood and in antibiotic resistance of all Gram-negative rods. 2. The empiric therapy with piperacillin/tazobactam plus amikacin in children with cancer treated in the Haematology Clinic seems to be the optimal option, but the monitoring of antibiotic susceptibility of bacterial strains is still required.

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Session Details

Date: 01/08/2007
Time: 00:00-00:00
Session name: XXIst ISTH Congress
Subject:
Location: Oxford, UK
Presentation type:
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